Top Reasons LFP Claims Get Rejected (and How to Avoid Them)

Official source

This article is based on the LFP Payment Schedule dated February 23, 2026.
View the full schedule here.

 

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Disclaimer

This article supports the use of the Aeon EMR. Billing decisions remain the responsibility of the physician. Always consult MSP guidelines and the LFP Payment Schedule for authoritative rules.

 

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Last reviewed

April 30, 2026

 

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In This Article

Overview
Most Common Reasons LFP Claims Are Rejected
🔹Incorrect Interaction Code (Locum vs Non-Locum)
🔹Missing “Referred From” Fields (Locum Claims)
🔹Incorrect Use of the Generic LFP Patient
🔹Incorrect Diagnostic Code (ICD-9)
🔹Missing or Incorrect Time Code Fields
🔹Billing Time and Interaction Codes Incorrectly
🔹Missing Facility or Location Information
🔹Billing in an Unregistered Setting
🔹Insufficient Documentation
🔹Unusual Billing Patterns
How to Avoid Rejections in Aeon
Bottom Line

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Overview

Under the LFP Payment Model, physicians submit:

• Time Codes (daily cumulative time)
• Interaction Codes (per patient encounter)
• Panel Reporting (PAS)

According to MSP billing rules, claims that are incomplete, incorrectly structured, or unsupported by documentation may be rejected, refused, or audited.

This article outlines the most common issues and how to avoid them when using Aeon.

 

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Most Common Reasons LFP Claims Are Rejected

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1. Incorrect Interaction Code (Locum vs Non-Locum)

Issue:

• Using non-locum codes (e.g., 98031) instead of locum codes (e.g., 98061)
• Mixing locum and non-locum codes in the same workflow

Why it matters:

• MSP treats locum claims differently
• Incorrect code selection may result in rejection

How to avoid:

• Use 9806x codes for locum interaction claims
• Use 9803x codes for non-locum claims

 

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2. Missing “Referred From” Fields (Locum Claims)

Issue:

• Missing Host Physician name or MSP number

Why it matters:

• Locums bill on behalf of a host physician
• Claims without this linkage may be rejected

How to avoid in Aeon:

• Open Advanced in the Billing Entry
• Enter:
  • Referred From Practitioner Name
  • Referred From Practitioner MSP Number

 

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3. Incorrect Use of the Generic LFP Patient

Issue:

• Using a real patient for time codes
• Not using the LFP “Time” patient

Why it matters:

• As of Feb 23, 2026, all time codes must be billed using the generic LFP patient

How to avoid:

• Use:
  • Last Name: Time
  • First Name: LFP
  • PHN: 9646191917

 

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4. Incorrect Diagnostic Code (ICD-9)

Issue:

• Using L23 for interaction claims
• Missing ICD-9 codes entirely

Why it matters:

• ICD-9 is required for all claims
• L23 is specific to time codes only

How to avoid:

• Use:
  • L23 for time codes only
  • Patient-specific ICD-9 codes for interaction claims

 

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5. Missing or Incorrect Time Code Fields

Issue:

• Missing start and end times
• Units not matching actual time
• Including breaks (e.g., lunch)

Why it matters:

• MSP requires:
  • Start time
  • End time
  • Total units (15-minute increments)

How to avoid:

• Track time accurately
• Exclude breaks
• Ensure:
  • 1 unit = 15 minutes

 

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6. Billing Time and Interaction Codes Incorrectly

Issue:

• Double counting the same work
• Misunderstanding how the two relate

Why it matters:

• Interaction codes support validation of time billing
• Incorrect overlap may trigger review

How to avoid:

• Bill:
  • Interaction codes per patient
  • Time codes as daily totals
• Do not treat interaction codes as additional time

 

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7. Missing Facility or Location Information

Issue:

• Missing Facility Number
• Incorrect Service Location Code

Why it matters:

• Claims must match the registered LFP setting

How to avoid in Aeon:

• Confirm:
  • Facility Number is entered in Settings
  • Service Location = L (typically)

 

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8. Billing in an Unregistered Setting

Issue:

• Billing LFP services in a setting that has not been registered

Why it matters:

• Physicians must register each setting using:
  • 98002, 98003, 98004, 98006

How to avoid:

• Confirm all applicable settings are registered before billing

 

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9. Insufficient Documentation

Issue:

• Missing or incomplete chart notes

Why it matters:

• According to MSP:

  A service without an adequate medical record is not payable

How to avoid:

• Ensure every claim is supported by:
  • Chart notes
  • Clinical context
  • Appropriate documentation

 

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10. Unusual Billing Patterns

Issue:

• High time billed with very few interactions
• Unusual ratios of work

Why it matters:

• May trigger:
  • Claim review
  • Audit

How to avoid:

• Maintain reasonable alignment between:
  • Time billed
  • Patient encounters
• Ensure documentation supports your work

 

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How to Avoid Rejections in Aeon

• Review claims before export
• Use Draft status for incomplete entries
• Confirm all required fields are completed
• Export claims per practitioner
• Verify claims again in ClinicAid before submission

 

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Bottom Line

Most LFP claim rejections are caused by:

• Missing required fields
• Incorrect code selection
• Improper structure of time vs interaction billing

Following the correct workflow in Aeon and aligning with MSP billing rules will significantly reduce rejected claims.